13. Teething

The cutting of the teeth is not in the real sense of the word an "ailment" at all. It is a natural physiological process. But mismanagement and maternal ignorance often make teething a painful and dangerous period for the baby.

Good management in the nursery ensures that baby will cut his teeth without anyone being aware of the process until they appear singly or in pairs through the gums. Most of the ailments attributed to the teeth are the result of improper feeding, of unhygienic nurseries, and unhealthy home conditions.

The healthy, well-managed infant will pass through the teething stage without pain or marked discomfort. The badly fed child will suffer from diarrhoea or convulsions, and will feel the strain of teething.

Temporary Teeth

Everyone has two sets of teeth. The temporary set consists of twenty teeth; it appears during the first thirty months of life, and ought to be complete in two and a half or three years. The complete set consists of eight incisors, the four upper and four lower front teeth, the four canines or eye teeth, which are placed one at each end of the incisors in both upper and lower jaws, and the back teeth, molars or grinders, two of which are placed on each side of both jaws.

The lower incisors usually appear first in the sixth or seventh month. The upper incisors should be cut by the ninth month, and the lateral incisors by the tenth month. The first molars appear about the end of the first year, then the eye teeth at the end of eighteen months. The remaining molars usually are complete when the child is two or two and a half years of age.

Sometimes the teeth appear earlier. Cases have been cited of a baby being born with a tooth, and occasionally a tooth may appear about the third month. Late teething is an evidence of debility, and rickets delay teething considerably.

The " cutting of a tooth " through the gum is generally associated with increased flow of saliva and dribbling. The gum may be a little tender from local inflammation, but no other signs should be present under normal conditions.

Milk teeth in right half of lower jaw. Section to display bags in which second set are contained

Teething Troubles

The chief factor which promotes painless teething is careful diet. Until the teeth appear, the one food for all infants is milk. If the mother is unable to nurse her own child, cow's milk, diluted with barley-water, should be given. The preparation, and so forth, of this diet for different ages, have been described under the articles on infant feeding. (Page 2416, Vol. IV.) Digestive disorders are the chief danger during teething. This trouble can be lessened, and considerable pain and risk can be avoided if the mother takes reasonable precautions. She should

1. Attend carefully to the diet, feed the child regularly only at stated times, and should rely upon milk, because it is the natural food of all young animals.

2. If the child is "on the bottle," pay the closest attention to cleanliness by boiling the bottles, teats, and valves daily, and scalding milk jugs and bottles after use. She should, moreover, take steps to protect the milk from infection by flies, especially in hot weather.

Milk teeth in right half of upper jaw

3. Make quite sure that she has a supply of pure milk from healthy cows.

4. Never permit the use of a comforter

The comforter is one of the greatest sources of trouble during the age of teething. In the first place, it is invariably dirty, medically speaking.

Secondly, the constant sucking action encourages an abnormal flow of saliva, and tends to the formation of adenoid growths.

Thirdly, it causes deformities of the jaw and irregularity of the teeth.

The bronchial attacks or " colds " which are said to be due to " teething " are very frequently the result of excessive dribbling which is set up by constantly sucking a dummy teat. The moisture soaks through the bib and clothing, and a chill results. A jaconet bib must always be worn underneath the ordinary bib to protect the chest. An ivory ring which is frequently boiled is often useful for a child to bite against.

Restlessness and irritability may be present when a child is cutting a tooth. A hot bath at bedtime will induce sleep.

A simple aperient, such as cascara, magnesia, or castor oil, should be given if there is the slightest evidence of gastric disturbance.

Wash the mouth from time to time with a piece of clean cotton-wool dipped in boracic solution.

Tenderness of the mouth or any patch of ulceration should be treated by brushing the mouth with a camel-hair brush, dipped in glycerine and borax, in the strength of a tea-spoonful of borax to a wineglassful of glycerine.